Testing Testing Everywhere But Not Much Has it Helped

Governor Bill Lee, like President Trump, underestimated the coronavirus. He lifted the lockdown too soon. The virus has surged and 8,391 people have died.

NASHVILLE, TN – In Governor Bill Lee’s mind unwavering support of Donald Trump and a fiercely held belief in personal responsibility somehow co-exist. The coronavirus has no opinion about Trump or about Lee’s ethical beliefs. Unfortunately, both men woefully underestimated the virus and Tennesseans have paid a heavy price for their mistakes.

Just before Christmas, Lee announced new COVID-19 cases increased by 90% from the previous week and that they were three times what they had been on Halloween.

“We have seen firsthand that Thanksgiving gatherings and extended time indoors have been the principal driver in spreading COVID-19 like wildfire. It only took a matter of days to see gatherings around Thanksgiving translate into a record level of sickness,” Lee said.

Actually, infections have been on the rise since May 1 when Lee ended the lockdown on Tennessee businesses. After surging in July, the virus slowed a bit but the infections began to increase again in October. Then on November 25, the Governor issued an order limiting indoor public gatherings to 10 people. High school sports would continue but attendance would be limited. Lee asked employers to let employees work from home for the next month and if that wasn’t possible, people should wear masks at work.

“Tennesseans have two weapons that they must use in the next 30 days: only gather with your household and wear a mask.” Lee said. He has been asked many times why he hasn’t issued a mask mandate, and the Governor has always answered that voluntary compliance works better. All this was too little too late.

A recent Mayo Clinic study found 6 feet of separation reduces virus particles to near baseline levels and concluded that that wearing a mask is the most important measure for reducing the risk of infection. A Cambridge study found that masks can prevent asymptomatic people from spreading the virus to other people.

A new study published in Annals of Internal Medicine, found that a combination of distancing and mandatory masks prevents 87% of COVID-19 infections and costs only $170 per infection prevented. Adding routine testing to those measures would stop 92%-96% of COVID infections. That is just as good as the Pfizer vaccine but the cost per case increases to $2,000 to $17,000 depending on how often a person is tested.

While social distancing and wearing masks are effective, getting everyone to comply is not easy. According to a Gallup poll conducted in April, only 36% of Americans said they always wore a mask while out, with 32% reporting that they sometimes did and 31% saying they never did.

When Lee ended the statewide lockdown last May, he let restaurants and retail stores reopen at 50% capacity. He said that would  “safely reboot” the economy while keeping employees, employers and customers safe. It didn’t.

Lee opened Tennessee too soon. On May 15 there were 271 new cases. By June 15, there were 728. On July 15 there were 2273 new cases, more than double the June count. By December 15, new cases rose to 8251. By January 16, 2021, all cases totaled 680,847.

There was no huge spike in cases after Thanksgiving. Infections have been on a steadily steepening rise since Lee ended the lockdown May 1. (See total cases graph) That has caused the pandemic to become a plague on all of our houses. Washington has about the same population as Tennessee and it’s where the pandemic started in the U.S. last March.

Washington’s Governor, Jay Inslee, told CSPAN that his state is doing better than 45 others because they took aggressive measures to stop the pandemic and didn’t let up. Tennessee has had 8,391 COVID deaths. Washington has had 3,903. If we had been more like Washington, 4488 Tennesseans would still be alive today.

We looked at testing data from August 16 to December 29. We found about 1/3 of labs did not get test results back within a 48-hour window that experts say is necessary to effectively trace contacts and stop the virus from spreading. About two thirds of the labs had 14-day maximum turnaround times between 10 and 30 days.

The data suggests COVID-19 is running rampant in Tennessee because testing has failed and the virus is infecting people faster than they can be detected and isolated so they don’t spread the disease.

If you look at testing data over time (see Test graph), infections really start to increase around May 1 and never slow down. Testing data also shows how the vast majority of all coronavirus tests are negative.

New COVID-19 tests have increased from under 10,000 per day from March-June to more than 20,000 tests per day in July. New tests in January 2021 are between 20-30 thousand a day. In short, testing has increased over time and it hasn’t slowed down the pandemic.

The Tennessee Department of Health has had about 30 labs reporting COVID test results since March. On December 18, the number of labs more than doubled to 65 and on December 29, there were 73 labs reporting.

There are three types of COVID tests. Molecular tests (aka RNA or PCR) collect mucus from your nose or throat and the lab uses a polymerase chain reaction (PCR) to detect the virus’s genetic material.

Antigen tests (aka rapid test) get results in about an hour. They work the same way as PCR tests. Your health provider swabs the back of your nose or throat to collect a sample. It doesn’t have to be sent to a lab to be read so it is also called a point-of-care test.

Antibody test (aka serology test or blood test) looks for antibodies to the coronavirus. Antibodies are proteins your immune system produces to fight off a foreign invader, like COVID-19.  A blood test can’t tell you’re positive only that you once were. Antibodies do not become detectable until at least several days after an infection has started.